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Back  RFI # 335: Pricing Methodology

Formal vs. Informal Help Informal Formal

Submitter

Christy Pidanick

Description

The HCP segment at the claim level and line level have a note in the IG stating:

"Trading partners need to agree on the codes to used in this element. There do not appear to be standard definitions for the code elements."

The meaning of this statement is that the code set listed in the IG are the only values allowed in the HCP01, it is just the usage of the listed values that need to be agreed upon. Correct?

Submitter Assigned Keywords

pricing methodology

Response

This issue is explicitly addressed in guide 004010X098. Section 1.1.1 states "It is important that these trading partner agreement NOT:... Utilize any code or data values which are not valid...". You are correct, the listed codes are the only valid codes for this element. The business usage (meaning) of those codes must be established by the trading partners.
Submission 10/12/2005
Status Date 10/27/2005
Status F - Final
Primary References
Document 004010X098A1
Section3.1
Page271
Set ID837
Table2
Loop2300
Segment Position241
Segment IDHCP
Element Position01
Industry NameName Claim Pricing/Repricing Information